Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers

Ickovics, Jeannette R.; Earnshaw, Valerie A.; Lewis, Judith A.; Kershaw, Trace; Magriples, Urania; Stasko, Emily C.; Rising, Sharon Schindler; Cassells, Andrea; Cunningham, Shayna D.; Bernstein, Peter S.; Tobin, Jonathan N.

doi:10.2105/ajph.2015.302960

Cited by 131 publications

(154 citation statements)

References 33 publications

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“…Randomized controlled trials demonstrating improved outcomes among women and newborns after participation in group ANC compared with standard ANC have been conducted in the United States7, 8, 9, 10, 11, 12 and Sweden,13 which the World Bank classifies as high‐income economies, and Iran,14, 15 which is classified as an upper middle‐income economy. Published benefits include increased uptake of postnatal family planning services, greater gestational age at birth and birth weight, lower incidence of sexually transmitted infections, healthier maternal weight trajectories, fewer depressive symptoms, and increased satisfaction with care 16.…”

Section: Introductionmentioning

confidence: 99%

Use of a Facilitated Group Process to Design and Implement a Group Antenatal and Postnatal Care Program in Rwanda

Sayinzoga¹,

Lundeen²,

Gakwerere³

et al. 2018

J Midwife Womens Health

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IntroductionThe government of Rwanda is exploring strategies that may reduce the incidence of prematurity and low birth weight. Large‐scale implementation of group antenatal care (ANC) and postnatal care (PNC) within the context of the Rwanda national health care system is under consideration. To launch a cluster randomized controlled trial of group ANC and PNC in 5 districts in Rwanda, the implementation team needed a customized group care model for this context and trained health care workers to deliver the program.ProcessAdapting the group ANC and group PNC model for the Rwandan context was accomplished through a group process identical to that which is fundamental to group care. A technical working group composed of 10 Rwandan maternal‐child health stakeholders met 3 times over the course of 3 months, for 4 to 8 hours each time. Their objectives were to consider the evidence on group ANC, agree on the priorities and constraints of their ANC delivery system, and ultimately define the content and structure of a combined group ANC and PNC model for implementation in Rwanda. The same group process was employed to train health care workers to act as group ANC facilitators.OutcomesA customized group ANC and PNC model and guidelines for its introduction were developed in the context of a cluster randomized controlled trial in 36 health centers. Descriptions of this model and the implementation plan are included in this article.DiscussionOur experience suggests that the group process fundamental to successful group ANC and PNC is an effective method to customize and implement this innovative health services delivery model in a new context and is instrumental in achieving local ownership.

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Section: Introductionmentioning

confidence: 99%

Use of a Facilitated Group Process to Design and Implement a Group Antenatal and Postnatal Care Program in Rwanda

Sayinzoga¹,

Lundeen²,

Gakwerere³

et al. 2018

J Midwife Womens Health

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“…Data were drawn from the control condition of a randomized controlled trial testing the efficacy of group prenatal care versus standard individual prenatal care (Ickovics et al, 2015). Fourteen study sites in New York City were randomized.…”

Section: Methodsmentioning

confidence: 99%

Discrimination and excessive weight gain during pregnancy among Black and Latina young women

Reid

Rosenthal

Earnshaw

et al. 2016

Social Science & Medicine

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Rationale Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. Objective We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. Method Participants were 413 Black and Latina pregnant young women, ages 14-21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. Results Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. Conclusion Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women.

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“…[8] Moreover, healthier weight trajectories; less weight gained during pregnancy and more weight lost postpartum, beside a reduction in babies born small for gestation age were observed among women received group prenatal care. [9,10] 1.1 Significance of the study Lack of social and psychological support in antenatal care was perceived by 56.1% of the pregnant women and 86.3% perceived that the individual prenatal care is not apt familial participation in care. [3] Despite that, this model of prenatal care still provided in most of the clinical sites.…”

Section: Introductionmentioning

confidence: 98%

Effect of applying centering pregnancy model versus individual prenatal care on certain prenatal care outcomes

Marzouk

Abd-Allah

Shalaby

2018

CNS

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Objective: This study aimed to compare effect of applying centering pregnancy model (CPM) versus individual prenatal care on certain prenatal care outcomes. Methods: A quasi experimental research design was followed. A purposive sample of 216 pregnant women without medical or obstetric problems requiring individualized care, was recruited from the Antenatal Outpatient Clinics of Mansoura University Hospitals, Egypt. Participants were randomly assigned to receive prenatal care under CPM or individual prenatal approach. Data were collected for the healthy behaviors adoption using Pregnancy-relevant Health Behaviors scale, women's extent of troubling about pregnancy physical discomforts using a Pregnancy Symptoms Distress scale, and women's satisfaction with prenatal care using Patient Participation & Satisfaction Questionnaire. Results: Post-intervention, CPM group equated to individual care group experienced lower distress about experienced pregnancy physical discomforts (8.06 ± 2.40 vs. 15.42 ± 3.84 respectively; t = 16.89 & p < .001), reported higher engagement to pregnancyrelevant health behaviors (37.71 ± 2.91 vs. 29.78 ± 4.3 respectively; t = 15.59 & p < .001), and higher satisfaction with and participation in care (80.8 ± 10.4 and 63.8 ± 11.1 respectively, t = 11.62 & p < .001). Conclusions: Hypotheses of the current study were accepted where CPM of prenatal care was associated with increased women adoption to the pregnancy-relevant healthy behaviors, reduced women distress about the experienced pregnancy physical discomforts and increased women participation and satisfaction about prenatal care.

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Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers

Cited by 131 publications

References 33 publications

Use of a Facilitated Group Process to Design and Implement a Group Antenatal and Postnatal Care Program in Rwanda

Use of a Facilitated Group Process to Design and Implement a Group Antenatal and Postnatal Care Program in Rwanda

Discrimination and excessive weight gain during pregnancy among Black and Latina young women

Effect of applying centering pregnancy model versus individual prenatal care on certain prenatal care outcomes

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